Registration Form

Mail to:

Anna Marie's Academy of Dance

7201 Marsden Street

Philadelphia, PA

19135-1224

215-332-3636

Complete this form and return as soon as possible with a $25.00

NON-REFUNDABLE registration Fee

So that we are able to save a spot for your child

Student's Name

Address

City, State, Zipcode

Date of Birth

Parent/Guardian

Home Phone Number

Work Number

Cell Phone

Type of Class(es) you wish to register for:

Have you attended dance classes in the past?

If yes, where did you study, which type of dance and how long?

How did you hear about our Studio?

In case of Emergency CONTACT: